Romneycare vs. Obamacare: Lessons for today's 'shutdown' debacle

You won’t hear many Republicans say it, but Mitt Romney’s health-care insurance program in Massachusetts, seen as a model for the Affordable Care Act, has been largely successful and popular.

Manuel Balce Ceneta/AP
Former Massachusetts Gov., and 2012 Republican presidential candidate, Mitt Romney at the annual Conservative Political Action Conference in National Harbor, Md., in March.

Back during the 2012 presidential campaign, President Obama had fun tweaking his Republican opponent about “Romneycare,” the health-care insurance program Mitt Romney had cited as one of the key successes of his time as governor of Massachusetts.

Romneycare, Mr. Obama said over and over, had been the model for the Affordable Care Act – "Obamacare" – now at the center of a highly toxic congressional debate that could see a government shutdown when the new fiscal year begins at midnight Monday.

[Latest update: The Republican-led House has tied a spending bill that would avert a shutdown to delaying Obamacare for one year. That kicks it back to the Senate, where Democratic leaders say that’s a no-go. The Senate isn’t scheduled to meet again until Monday, just hours before many federal programs could halt or be slowed down as hundreds of thousands of civilian employees are furloughed.]

Mr. Romney signed the Massachusetts program into law in 2006. So seven years later, how has it done? More to the political point, what do people in the Bay State think of their health-care insurance system – which, like Obamacare, includes an individual mandate requiring everyone to obtain coverage or face a fine and a marketplace where the uninsured can purchase coverage?

At first, there was a lot of skepticism in Massachusetts – from those on the right against “socialized medicine,” and from those on the left pushing for a single-payer system.

The Providence Journal next door in Rhode Island had this to say about Romneycare on its editorial page Sunday:

“The big difference between the programs is that the federal version puts more emphasis on controlling costs. That makes Obamacare arguably more conservative than the original Romneycare.

“For example, Obamacare proposes bundling payments for a medical condition. That means payment will be a set amount covering the soup-to-nuts treatment for an ailment, such as foot surgery. That removes incentives for ordering more tests or treatments than needed – while rewarding medical providers for doing a good job the first time around.

“It bears noting that Massachusetts is less generous in determining who gets subsidies. It helps pay for the coverage of those earning up to 300 percent of the federal poverty level. The federal government sets the limit for subsidies at up to 400 percent of the poverty level.”

So Obamacare is “more conservative” than Romneycare (at least in its original form), according to this analysis.

Romneycare got tweaked over the years, including in ways that control costs. As a result, the Providence newspaper points out, the fiscally conservative Massachusetts Taxpayers Foundation has called Romneycare “a well thought-out piece of legislation.”

“There’s a lot of wild accusations that the law is breaking the bank in Massachusetts, and that is simply not the case,” foundation president Michael Widmer told Forbes during the 2012 presidential campaign. “I think the state’s healthcare reform has been a huge success and is probably the best policy achievement in the last 25 years.”

A recent poll by the Massachusetts Medical Society, a statewide physician group, finds that most people in Massachusetts today are generally satisfied with the health-care system there.

“Eighty-four percent of residents expressed satisfaction with the care they received over the last year, including 56 percent who indicated they are ‘very satisfied’ and 28 percent who are ‘somewhat satisfied,’” the survey report states. Seventy-three percent of residents reported that gaining access to health care they need is “not difficult,” and for serious medical problems, 86 percent said the amount of time they needed to wait was not a problem.

While no health-care insurance system – private or public – is perfect, the bottom line in Massachusetts, as the Hill newspaper in Washington reported last month, is that “The vast majority of Massachusetts residents are satisfied with their healthcare under the state's 2006 reform law.”

That may have been what Sen. Ted Cruz (R) of Texas – chief opponent of Obamacare – was worrying about recently.

Speaking to fellow conservative Sean Hannity on Fox News, he warned that Americans would become so happy with Obamacare – “addicted” is the word he used – that opponents like himself would never be able to kill it.

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